PicoSure, the proven performer for skin revitalisation

PicoSure has transformed the skin rejuvenation landscape, providing a minimal downtime technique that improves the quality, appearance and elasticity of all skin types.

By combining picosecond technology with the FOCUS Lens Array handpiece, Cynosure has developed a system that delivers 20 times the power of the original PicoSure, achieving impressive and quantifiable results in skin rejuvenation.

The FOCUS Lens Array can be considered a widely applicable device, suitable for a broad range
of treatment parameters and skin types.

“PicoSure works very well for tattoo removal, but we didn’t initially realise the possibilities it offers for the rejuvenation of the skin,” says Dr Emil Tanghetti, a leading dermatologist and laser specialist from California. “PicoSure does a lot more than treating the superficial layer. It targets deeper layers to improve collagen and elastin, breaking down pigmentation without damaging the skin. For Asian skin and darker skin types I have not experienced any adverse effects.”

Backed by a wealth of clinical studies and research, and more than 500,000 patients treated, PicoSure’s optimal 755nm wavelength and FOCUS Lens Array stimulates the natural cell-signalling processes to effectively treat pigmented lesions, acne scars and wrinkles.

“With any device, you want to understand how the company works in terms of clinical evidence. PicoSure has years of clinical evidence, studies and a lot of reliable data. Clinical trials are the safest and most efficient way to identify treatments that work. It’s disconcerting when other devices don’t have this,” says Dr Tanghetti.

How PicoSure works

The FOCUS Lens Array creates a high-energy spatially confined injury to the epidermis, referred to as an area of Laser Induced Optical Breakdown (LIOB). In the LIOB reaction, a vacuole is created by high pressure, causing a chain reaction in the dermal architecture and resulting in dermal remodelling.

The injury in the epidermis triggers a chain reaction, which improves collagen and elastin. A smoothening of fine lines and wrinkles, normalisation of pigment and improvement of scars is achieved.

Brisbane dermatologist Dr Davin Lim explains, “The FOCUS Lens Array basically attenuates laser energies by approximately 90% and fractionates or diffuses the laser into fractions which are at different levels. This allows a higher safety margin. The lens itself can be adjusted from 6mm spot size through to an 8mm and a 10mm spot size. Accordingly, the fluence or energy levels can be varied within each spot size.”

The toning effect of the handpiece in combination with the picosecond pulse duration is effective in
treating epidermal pigmentation. The dual mechanism heats and fractures melanosomes to diminish pigmentation.

Dr Shamshik Shin of Clear Dermatology and Laser Clinic in South Korea says, “The 755nm FOCUS Optic has opened a new way to treat facial pigmentation inconsistencies. The fractional delivery of energy appears to be well suited to all skin types without the problem of hyperpigmentation and rare scar formation from the 1064nm Q-Switched procedures.”

“By confining the high fluence in the microspots, the FOCUS Optic allows for the treatment of challenging conditions while keeping the safety profile very high due to the low background fluence. This delivery method coupled with the picosecond pulse duration has allowed for the use of PicoSure 755nm on darker skin types,” he says.

“The appeal of the technology is its non-thermal mechanism of action, specifically with the 500-750 picosecond pulse duration. The effect on pigmentation disorders and tattoos is one of a photoacoustic rather than principally photothermal effect,” says Canadian plastic surgeon Dr Stephen Mulholland.

“Without a significant photothermal effect, the risk of hypopigmentation and inflammation disappear and a more efficient shattering of the tattoo pigment and hyperpigmentation disorders occurs, with more effective and rapid removal. The traditional complications of nanosecond technology, resistant ink and hypopigmentation become less frequent,” explains Dr Mulholland.

PicoSure is unique in that there are no other lasers on the market that can give such marked dermal remodelling with minimal to no redness on all skin types.

Prof Henry Chan from the Dept. of Medicine, Univeristy of Hong Kong says, “PicoSure is a safe
and highly effective modality of treatment for unwanted epidermal and dermal pigment conditions in Asian skin types.
It is a valuable tool for the management of melasma among those who failed to improve with topical therapy. It allows more rapid and predictable response than previous Q-Switched lasers. I have three Pico technologies in my practice; PicoSure is my go-to technology when it comes
to skin revitalisation.”

As well as the FDA-cleared and TGA-listed 532nm and 755nm, Cynosure has recently introduced a 1064nm laser delivery system for all skin colours, treating darker skin types V and VI without the risk of hypopigmentation.

Dr Lim says it is his preferred choice for the treatment of melasma and difficult hyperpigmentation disorders. He says, “I typically treat darker skin types, as this laser preselects melanin as the chromophore. I normally would recommend other fractionated devices for type I and type II skin, but PicoSure is my laser of choice for type III skin and beyond.”

“My skin rejuvenation practice has been transformed with this fractional picosecond technology, providing a short downtime, full face, neck or hand rejuvenation technique that improves the quality, appearance and elasticity of the skin (and is one of the few things that actually produces elastin versus collagen). It is my go-to choice for the treatment of melasma and difficult hyperpigmentation disorders,” says Dr Mulholland.

An integral part of modern-day practice

As the non-excisional market continues to grow, the immediate future of anti-ageing and rejuvenation medicine very much lie in the ongoing combination of efficacious treatments such as PicoSure.

Dr Mulholland says devices such as PicoSure have become an integral part of his practice offering. “As a plastic surgeon, 50% of my income is now from non-surgical treatments. Energy-based devices such as PicoSure have become a big part of plastic surgery,” he says.

“Eighty-four percent of all procedures are now non-invasive. These non-invasive treatments require energy-based devices, injectables and skincare, and a modern plastic surgeon needs to have access to the non-excisional as well as the excisional market to be truly competitive.” AMP

For enquiries contact Cynosure at medprac@cynosure.com